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Chinese Journal of Clinical Pharmacology and Therapeutics ›› 2025, Vol. 30 ›› Issue (1): 78-84.doi: 10.12092/j.issn.1009-2501.2025.01.009

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Effects of esketamine-mediated opioid-free anesthesia on delirium in elderly patients after hip replacement

HUA Hao1, HE Teng2, LI Xin1, CHEN Xiaodong1, LIU Zhenqing1, LIU Kun1, ZHANG Qi2, JIANG Lin3, LIU Cunming2, WANG Meng1, YANG Chun2   

  1. 1 Department of Anesthesiology, Wuxi 9th People's Hospital Affiliated to Soochow University, Wuxi 214062, Jiangsu, China; 2 Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu, China; 3 Department of Anesthesiology, Taizhou People's Hospital Affiliated Hospital of Nanjing Medical University, Taizhou 225300, Jiangsu, China
  • Received:2024-01-29 Revised:2024-05-27 Online:2025-01-26 Published:2025-01-02

Abstract:

AIM: To observe the effect of opioid-free anesthesia with esketamine on delirium after hip replacement surgery in elderly patients. METHODS: One hundred and fourteen elderly patients who underwent hip replacement were randomly divided into two groups: opioid-free anesthesia (OFA) group and opioid anesthesia (OA) group (n=57). During anesthesia induction and maintenance, esketamine was administered in OFA group, and that fentanyl and remifentanil were administered in OA group. Delirium was mainly recorded within 3 days after the surgeries, and the patients' delirium status was evaluated using the Chinese Revised Delirium Diagnostic Scale (CAM-CR). RESULTS:The patients in OFA group had lower CAM-CR scores and delirium incidence compared to those in the OA group at 2 days after surgery. CONCLUSION: Opioid-free anesthesia based on esketamine can effectively reduce delirium after hip replacement in elderly patients.

Key words: esketamine, opioid-free anesthesia, elderly patients, delirium, analgesia

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